Surgical handpiece



April 1959 N. ROBBINS 2,881,763

S URGICAL HANDPIECE Filed Aug. 30, 1956 I N V EN TOR. 054 Roam/VsPatented Apr. 14, 1959 2,881,763 SURGICAL HANDPIECE Noel Robbins,Chatham, NJ. Application August 30, 1956, Serial No. 607,217 4 Claims.(Cl. 128355) This invention relates to surgical instruments andparticularly to an improved handpiece for a planing brush fordermabrasion, otherwise known as corrective surgical skin planingprocedure.

The planing brush may be of the type disclosed in United States PatentNo. 2,712,823 and is circular in shape. an inch in diameter and is madeup from one to seven layers of metallic bristles, usually of stainlesssteel, each layer being about three thirty-seconds inch in thickness.The bristles are radially extending and each bristle has a diameter ofabout three-thousandths inch. The several layers of bristles arecompressed by two circular holding members and secured to a widenedportion of the mandrel. The radially extending bristles project from thecircumference of the holding members for a distance of aboutone-sixteenth of an inch and point in the direction of rotation of saidmandrel at an angle of about thirty degrees. Such a planing brush, ifmade up of one section only, has the edge of the compressed mass ofbristles trimmed so as to give it a rounded shape. The mandrel of theplaning brush is locked fast to a shaft of the handpiece which isrotated by an electric motor attached to a flexible cable at speeds from8,000 to 23,000 revolutions per minute.

The purpose of the rotating planing brush is to produce a leveling andmacerating eifect upon skin scarred by a disease or upon a blemishmarking the skin. In using the planing brush, the treated skin is eitherinjected with anesthetic liquid or preferably frozen by spraying a lowboiling point volatile liquid thereon, the preferred liquid being ethylchloride or a Freon derivative or a mixture of both. The treated skinarea while remaining in frozen state is insensitive to pain, immobileand hemostatic.

The abrasion is produced by the shearing force of the Such a planingbrush is about three-quarters of i bristles of the rotating brush at itshigh speed of rotation t as it is held in the handpiece by a physicianand brought down vertically to make a contact upon the frozen area ofthe scar or blemish. The brush is then moved in short strokes up anddown or with a circular motion until the entire frozen area is abradedto a required depth. In such a technique a thin layer of the top of theskin, called epidermis, is removed. Such a technique of abrasion orsurgical planing is carried down through the epidermis, which is thesuperficial layer of the skin, to the varying levels of the dermisdepending on the depth of the scar. However, such an abrasion should notextend beyond the germinative zone of the corium in order to obtainregeneration of epithelium without scarring. Since the thickness ofepidermis and its layers of the entire skin ranges from 2 to 2.2 mm., asurgeon must control the instrument with great care lest he will abradedeeper beyond the upper layer of corium and cause hypertrophic scarring,which is a permanent disfiguration and related in its nature to akeloid. On the other hand, if the abrasion is not sufficiently deep, themacerating effect upon the pillocebaceous cells of the germinative zonewill be insignificant and no regeneration of the epithelial cells willtake place and no therapy of the scar would result. Thus, a repetitionof the abrasive procedure will be necessary. A further ditficulty in thetechnique of abrasion is presented by a limited time during which thetreated area, usually not over nine square inches, remains frozen, thusrequiring the surgeon to operate rapidly which, of course, is strenuousand fatiguing. Furthermore, the operative procedure requires that theplaning brush be moved across the skin in a direction at right angles tothe plane of the brush.

This is important as motion in the line of rotation may result ingrooving and permanent scarring of the skin. In this technique it isimportant to have a firm grip on the handpiece while the abrasiveprocess is being per.- formed, since there is a tendency for the brushto pull in the direction of rotation of the brush. If the surgeon iscareless or inexperienced, it is possible to lose control of the brushwhich will gouge or groove the skin beyond the area being abraded.

Another difiiculty presented by the use of the instrument results fromthe centrifugal force that drives the abraded material in a particulatestream away from the field. This stream of epithelial particles is soheavy that it has been found necessary for the physician to wearprotective clothing and a transparent face protection.

The present invention aims to overcome the foregoing difliculties byproviding an improved handpiece for a planing brush in which means areprovided for supporting the planing brush in relationship to the skinsurface.

Another object of the invention is to provide an improved handpiecewhich is simple and economical in manufacture, eflicient in operation,and rugged in use.

In accordance with the invention, this is accomplished by providing aguiding surface or rest for the planing brush in close proximity theretoand of semi-annular shape of approximately the same or slightly largerradius than the radius of the planing brush.

The present construction is advantageous in that it permits saferworking to the nostrils or eyes and gives great stability ofmanipulation. Additionally, a long moment arm is provided for the handleand a short moment arm for the planing brush. Therefore, a comparativelylarge movement of the handle is required to produce a small variation inthe depth of abrasion. The surgeon is thus able to rapidly manipulatethe instrument while it is in contact with the skin surface rather thanmaking the short overlapping strokes required by use of the priordevices.

Other objects and advantages of the invention will be apparent from thefollowing description and from the accompanying drawings which show byway of example an embodiment of the invention.

In the drawings:

Figure l is a side view of a handpiece in accordance with the inventionand showing a portion of a flexible power cable.

Figure 2 is a view corresponding to Figure 1 with the handpiece shown invertical section.

Figure 3 is an enlarged view of the handpiece.

Figure 4 is an end view of the handpiece.

Figure 5 is an enlarged portion of the end of the handpiece.

Figure 6 is an end view corresponding to Figure 4, but with the planingbrush removed.

Referring to the drawings, there is shown in Figure 1 a handpiece 1 inaccordance with the invention attached to a conventional flexible cablepower supply 2.

The flexible cable power supply 2 includes a coupling member 3 adaptedto be attached to any suitable cable power supply and which may be ofthe type used by dentists or for other surgical apparatus. An extremelyflexible portion 4 of conventional design is provided for easiermanipulation of the handpiece 1.

As may be seen more clearly in the cross-sectional portion of Figure 2,the handpiece 1 is made in tubular section with an open end 5 adapted tooverlie a bushing member 6 terminating the flexible portion 4 of thepower cable. The bushing member 6 extends inwardly within the tubularhandpiece 1 and has extending therefrom a shaft 7 and a chuck member 8to receive a shank 9 of a rotary planing brush 10. So far theconstruction is conventional.

In accordance with the invention, the handpiece 1 is provided with asleeve 11 which extends towards the planing brush terminating in agenerally annular guiding member or rest 12 providing a surface for thesupport of the handpiece adjacent the operative field.

The guiding member 12 in cross-sectional view is rounded or may be madeof any suitable cross-sectional shape providing ease of motion over theskin surface. Preferably the width of the guiding member 12 isapproximately of an inch. The diameter of the guiding member 12 ischosen so that it is equal to or preferably 1 to 4 millimeters largerthan the diameter of the rotary planing brush 10. As shown, the guidingmember 12 is made circular and extends completely around the tubularhandpiece 1; however, as will later appear, the guiding member 12 may beonly segmental in shape. At the outer end of the sleeve 11 is anextension or shield 14 which overlies the rotary planing brush 10extending outwardly as may be seen from the drawing slightly past theoutermost edge of the planing brush so that the stream of abraded skinmaterial is prevented from being thrown outwardly by centrifugal actioninto the face of the surgeon. The diameter of the extension or shield 14is such as to provide about /s of an inch clearance beyond the edge ofthe rotary planing brush 10.

The extension 14 extends annularly about the rotary brush 10 slightlymore than around one-half the circumference thereof. The outward cornerof the extension is curved as indicated at 15 to enhance the appearancethereof and to prevent the formation of a corner. Furthermore, thecurved surface 15 provides a support or rest in addition to thatprovided by the guiding member 12 which may be used effectively asdesired by the surgeon. The outer surface of the extension or shield 14is knurled or otherwise machined as indicated at 16, and also the outersurface of the tubular member 1 is knurled as indicated at the endthereof at 17 to provide a better grasp for the fingers of the surgeon.

In order to provide access to the chuck 8 for the replacement of theplaning brush 1t) and for its adjustment with respect to the guidingmember 12, an adjustment screw 18 is provided engaging in a threadedrecess 19 in the bushing 6. As indicated at 20, a longitudinallyextending slot 20 is provided axially of the sleeve 11 with the ends ofthe slot indicated at 21 and 22. By means of the slot 20, it is readilyapparent that the sleeve 11 may be moved within the limits of the slot20 back over the flexible portion 4 so as to expose the chuck 8 and theplaning brush 10. Additionally, when the sleeve 11 is moved outwardlyover the planing brush 10, any suitable desired adjustment may bemade'longitudinally with respect to the planing brush 10 of the guidingmember 12. It should be noted that in the inner side of the extension 14there is formed a tapered shoulder 23 against which may abut a sidemember 24 of the planing brush 10. However, it is preferable that therebe no contact, but that the members operate in close juxtaposition toeach other.

While the invention described and illustrated with reference to aspecific embodiment thereof, it will be understood that otherembodiments may be resorted to without departing from the invention.Therefore, the form of the invention set out above should be consideredas illustrative and not as limiting the scope of the following claims.

I claim:

1. An improved handpiece for a rotary skin planing brush for abradingskin deformities comprising a tubular handle member adapted to, receivea rotary planing brush at one end thereof, and an annular rest securedto an end of the handle member inwardly of the rotary brush, thediameter of the annular rest at least as great as the diameter of therotary planing brush with which it is to be used, the cross-sectionalshape of the annular rest generally rounded on its outer surface, theplane of the annular rest parallel to the plane of the rotary planingbrush, whereby by pivoting the annular rest on a skin surface thecontact of the rotary planing brush therewith may be varied so that adesired predetermined depth of cut may be produced.

2. An improved handpiece for a rotary skin planing brush according toclaim 1 in which the diameter of the annular rest is between 1 and 4millimeters greater than the diameter of the rotary planing brush withwhich it is to be used.

3. An improved handpiece for a rotary skin planing brush according toclaim 1 and including a shield for the rotary planing brush, the shieldoverlying the rotary planing brush the circumference at least one-halfthe periphery thereof.

4. An improved handpiece for a rotary skin planing brush, according toclaim 1 in which the width of the rounded surface of the annular rest isapproximately 7 of an inch.

References Cited in the file of this patent" UNITED STATES PATENTS1,115,337 Rossetter Oct. 27,. 1914 1,713,592 Blomquist May 21, 19291,915,305 Gallagher June 27, 1933 2,712,823 Kurtin July 12,1955 FOREIGNPATENTS 340,377 Great Britain Jan. 1, 1931

